Monday, January 7, 2013

Forget the statistics: I recently lost a friend to Tuberculosis


When I went to see him in his tiny hospital room at Makerere University hospital, in the outskirts of Kampala, he had easily lost a third of his normal body weight. 

Tugume Benon was still his old cheerful self. Cracking jokes even when he was in excruciating pain, physically a shadow of his former self. As if to defy the fate that grounded him to a rickety old hospital bed for days on end he kept cheering me  up instead.

‘''’Tell people not to worry about me. I will be fine and out of hospital in a few days.’’ he said. He told me he had been diagnosed with Tuberculosis (TB) and was on the dreaded six months- long DOTS regimen- the known treatment for TB.

True to his word, he was finally discharged from hospital. Well, not in a few days as he had predicted but in a matter of months.

'See, I told you. I told you I would be out of hospital. How is everyone? I am going around the office saying my hellos to friends'.

That was the last time I saw my friend alive.

About a month later, I got phone call  in the middle of the night to announce that Benon had finally succumbed to TB.

I was astounded. Benon had been on treatment and he been discharged from hospital and was making plans for the future and trying to resume his degree program.

Benon Tugume was in his mid forties-in the prime of his life. With a young wife and family. He had even gone on to study for a Bachelors degree two decades after his peers. He was in the second year of a three-year Bachelors' degree at Makerere University.

Many regard TB as an old vanquished disease. But TB is on the rise in Uganda.

According to UNAIDS, TB is the leading cause of death for people living with HIV/AIDS.

''Why spend billions of dollars on treating HIV/AIDS and let people die eventually of TB'' asks Prof Lee Reichmann, head of the New Jersey Global TB institute.

According to Dr Adatu, head of Uganda's national TB program, 60% of all people diagnosed with Tuberculosis in Uganda are also HIV positive.

The increasing prevalence of HIV/AIDS rates in Uganda, now projected at 7.3% compared to 6.4 in 2005, has driven up TB cases in the country and led to a re-emerging TB epidemic in the country.

People living with HIV are especially prone to Tuberculosis due to weakened immunity. According the International Union against Tuberculosis and Lung Disease, a third of healthy humans live with the TB bacteria in their bodies but are able to suppress it due to healthy immunity levels. This situation is similar to Candida in women which comes to the fore mostly when women’s' immunity levels decline.

Because of the widespread TB-HIV co-infection, a joint, integrated treatment is now standard procedure-according to the World Health Organization.

It is now advisable to test all those with TB for HIV and all those diagnosed with HIV for Tuberculosis.

How I wish I had had the guts to task my friend to go for an HIV test. Benon Tugume may still be alive today.

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